Expansion of Physician Assistant Rules in Wisconsin

On March 28, 2012, Wisconsin Governor Scott Walker signed 2011 Senate Bill 421 (the “Bill”) into law. The Bill expands the ability of Wisconsin-licensed physician assistants (“PAs”) to authorize certain medical actions by generally allowing PAs to act on behalf of patients’ and the public’s health in situations that were previously limited to physicians and advanced practice nurse prescribers. These areas are summarized below.

In nursing homes and residential facilities, PAs can now perform the following actions:

Limit residents from engaging in certain activities when medically contraindicated and documented in the patient record, such as:
- Participating in private and unrestricted communications with others;
- Participating in social, religious and community groups; and
- Sharing a room at the facility with a spouse or domestic partner.
Authorize the initial and continuing use of chemical and physical restraints for residents.

PAs may now document disability or illness by:

Providing a letter confirming the illness or disability of an individual to allow the individual to appear via telephone to object to a property tax valuation.
Providing documentation certifying health information for an individual applying for state subsidies for health insurance.

PAs may provide medical opinions regarding an individual’s risk to public health and safety by:

Reporting a patient to the Department of Transportation without the informed consent of the individual if the patient’s condition impairs his/her control over a motor vehicle (PA will not be held civilly liable for reporting in good faith or not reporting in good faith);
Reporting on the health of an individual obtaining or renewing an operator’s license;
Providing examinations, care and treatment for patients required to seek an examination for infectious or communicable diseases by a health officer;
Providing an opinion as to whether an individual has an infectious disease and whether that disease is communicable at the time of examination;
Reporting cases of sexually transmitted diseases to the Department of Health Services and, if necessary, testify to those facts before a court; and
Provide specimens for diagnosis of STDs to the state laboratory of hygiene.

PAs’ scope of practice is expanded to allow:

PAs to establish and review plans for furnishing home health services to patients; and
To provide a written referral for physical therapy services.

Finally, the Bill codifies existing practices such as the requirement for PAs to bill separately and the ability of PAs to make therapeutic alternative drug selections for their patients. The bill is available at: http://docs.legis.wisconsin.gov/2011/proposals/sb421.

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